A record 405,000 Pennsylvanians have signed up for health insurance through the state-run electronic marketplace selling coverage made available by the Affordable Care Act, also known as Obamacare, the state said this week.
The figure represents people who met the Dec. 15 deadline to sign up for coverage that becomes available Jan. 1. Signups will continue until Jan. 15, but coverage won’t kick in until Feb. 1.
State officials say it’s the highest level of enrollment since Pennsylvania established its own electronic marketplace in 2020. Pennsylvania’s marketplace, called Pennie, enables people to shop for health insurance plans and connects them to income-based subsidies to make coverage affordable and, for some, to help with deductibles and co-pays.
Prior to 2020, Pennsylvanians along with residents of most other states used the federal electronic marketplace to sign up for coverage.
But then Pennsylvania lawmakers unanimously approved a state-run exchange after concluding it would save millions of dollars that could be put toward lowering health insurance premiums and also enable the state to promote the coverage better.
About 360,000 Pennsylvanians had coverage bought through Pennie in 2023. Pennsylvania’s overall high water mark for ACA coverage bought through the federally-run marketplace came in 2015, when about 473,000 state residents bought coverage, according to data from the Kaiser Family Foundation. In 2023, 16.4 million people in the United States had marketplace coverage, the most ever.
Pennie officials say nine in 10 people qualify for financial help worth an average of $500 per month. Many people pay well under $100 in monthly premiums, and some pay under $20.
The coverage is intended for people who would otherwise struggle to afford health insurance, but earn too much to qualify for Medicaid. The financial help is structured so people pay no more than 8.5% of their household income toward their coverage.
The plans available through Pennie are the same as many people get through their job, from major insurers including Blue Cross-Blue Shield plans. They are approved by the state insurance department and must provide ten essential benefits such as emergency care, maternity care, preventive care, prescription drugs and mental health care. The plans also cover any pre-existing conditions.
Pennie does the work in terms of looking at applicants’ income and calculating how much help they receive toward premiums, with the financial help immediately applied to their premiums.
Still, the selection process isn’t totally automatic: Just like people who get coverage through their job, Pennie customers must evaluate and choose a plan based on factors including monthly premium, deductibles and co-pays. They should also make sure their preferred doctors and hospitals are part of the network for any plan they are considering.
But help is available: People can find abundant information including an online chat feature at pennie.com. Pennie also has a call center that offers help over the phone at (844) 844-8040, with in-person help available as well.
